Total Hip Replacement (THR) works 98% of the time.
Only cataract surgery beats that.
A modern THR could last you the rest of life. Implants remain function 98% at 10 yrs, 80% at 20 yrs and 65% at 30 yrs.
The implants at 30 yrs are older designs and so we expect those number to improve.
Don't under estimate the surgery - it is still hard work - but at 6 weeks most patients are markedly better than they were prior to surgery.
It is always good to consider non-surgical options.
The presence of arthritis on an X-ray does not immediately mean you need an operation.
A hip replacement is for pain, not to treat an X-ray.
If your pain can be managed and you remain mobile then surgery can be delayed, sometimes for ever.
The progression of arthritis in most people is quite slow, and it can take years to become disabled.
When you need medication every day to cope with pain, use a stick to walk, struggle to get on and off the toilet, and struggle to get in and out of a car, can no longer reach your toes to wash them, and have sleep disturbance: then it's time to think seriously about having a THR.
Some people make a decision before getting this bad, it's a personal choice, made in conjunction with Mr Knight
Every surgeon who completes their Orthopaedic training in Australia can do a successful hip replacement.
We train surgeons for precisely that reason. Some surgeons just do hip replacements, some decide never to do them. Most of us provide this operation for our entire careers because we are collectively very good at it.
With so many surgeons offering the same service there is bound to be differences in technique. There is excellent data in Orthopaedic journals that shows regardless of how the operation is performed the outcomes are statistically similar.
Anterior hip surgery hurts less. Patients go home usually one day earlier. In large studies it has the highest complication rate.
Posterior hip surgery has a lower post operative limp rate compared to Lateral hip surgery, otherwise they are largely the same.
Lateral hip surgery has the lowest dislocation complication rate.
Mr Knight does posterior hip surgery for arthritis and revisions.
For fractured neck of femur Mr Knight will do a lateral approach.
If anterior hip surgery is eventually shown to be better than the other two, Mr Knight will change technique, but at present there is no evidence for this and so he will continue with the techniques that have stood the test of time.
The best place to find this information is under the "Consent" page. Click here to go there.
This is a technical section. Don't worry if it doesn't make much sense. This information is really only for people who like to get into the nitty gritty of the operation.
The Australian Orthopaedic Association National Joint Replacement Registry provides a guide to the survivorship of individual joint replacement devices. A link can be found by clicking here.
On the basis of this information Mr Knight will perform an uncemented hip replacement on patients under the age of 70, who have no risk factors for osteoporosis.
Between 65 and 80 years of age, most patients will receive a hybrid hip replacement with a cemented femoral stem, and an uncemented acetabular cup.
Over the age of 80 all people would receive a fully cemented hip replacement, unless they had surprisingly good bone density, in which case he would use a hybrid.
For all neck of femur fractures the evidence suggests a cemented bipolar prosthesis is the best option.
The oldest person Mr Knight has performed a hip replacement on was 108 years old. The youngest was 14.
It is a person's global health and their pain disability that dictates whether they should have an operation not their age.
For each decade of age over 60 there is a 100% increase in the risk of surgery, however this applies to populations not to individuals.
Some 90 year olds are healthier than some 70 year olds.